Kornimate/medical-research-clean huggingface dataset:
controlled fluid resuscitation in sepsis

Conditions: Sepsis

Summary: to evaluate two different strategy of fluid resuscitation in sepsis patients

early goal-directed fluid therapy (egdt) had been regarded as an important fluid therapy strategy in early sepsis or septic shock patients. in recent years, several randomized control studies showed the egdt therapy cannot make a better outcome in sepsis patients compared to the standard therapy. a strategy of controlled fluid resuscitation had showed good outcome in critical illness such as severe acute pancreatitis, major trauma. but many aspects of the so-called controlled fluid resuscitation remained controversial. in a previous study on severe acute pancreatitis, we described a bundle of controlled fluid resuscitation which had showed an ideal result with higher survival rate. so, we are going to use the bundle on sepsis patients, and to see if it can bring a better out come in sepsis patients compared to the egdt strategy. this study aims to determine a better strategy of fluid resuscitation in sepsis patients

Eligibility criteria:
inclusion criteria: * 1.sepsis patients in accordance with the sepsis 3.0 definition(sofa increase ≥2 compared to the baseline，due to infection ) * 2.the first blood lactate in our hospital is ≥ 4mmol/l or map\<90mmhg after 20ml/kg fluid bolus * 3.the shock is diagnosed within 24hrs after onset exclusion criteria: * - 1.\<18 years old * 2.pregnancy * 3 with co-morbidity such as ae-copd, stroke, seizure, lung edema, acute coronary syndrome * 4 with contra-indication of cvc(central venous catheter) placement * 5 trauma or major burn * 6 poisoning * 7 any cancer receiving chemotherapy * 8.immunosuppression (for organ transplantation or disease of immune system) * 9.acute pancreatitis * 10.relapse sepsis

Keywords: resuscitation fluid therapy
head and neck cancer registry (lorhan)

Conditions: Head and Neck Cancer

Summary: the primary objective of this study is to describe, in detail, patterns of care for head and neck carcinoma patient


Eligibility criteria:
inclusion criteria: * pathologically (histologically or cytologically) confirmed new diagnosis of carcinoma involving the oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, or neck node metastasis from unknown origin * scheduled to receive radiotherapy and/or drug therapy including chemotherapy, biologic therapy and targeted therapy * written informed consent exclusion criteria: * registry participation does not exclude participation in clinical trials. * patients scheduled to receive or who have received surgery are eligible for registry participation as long as they are also scheduled to receive medical therapy.
blood markers predict effect of normobaric hypoxia at rest and during exercise in patients with pulmonary hypertension

Conditions: Hypertension, Pulmonary

Summary: to study the effect of acute normobaric hypoxia during exercise in patients with pulmonary hypertension on blood markers (serum markers of iron and red blood cell homeostasis and micro-rnas known to be associated with ph).


Eligibility criteria:
inclusion criteria: * informed consent as documented by signature (appendix informed consent form) * ph class i (pah) or iv (cteph) diagnosed according to guidelines: mean pulmonary artery pressure \>20 mmhg, pulmonary vascular resistance ≥3 wood units, pulmonary arterial wedge pressure ≤15 mmhg during baseline measures at the diagnostic right-heart catheterization exclusion criteria: * resting partial pressure of oxygen \<8 kilopascal at zürich altitude on ambient air * exposure to an altitude \>1000 m for ≥3 nights during the last 2 weeks before the study * inability to follow the procedures of the study * patients who take nitrates * other clinically significant concomitant end-stage disease (e.g., renal failure, hepatic dysfunction)

Keywords: hypoxia exercise blood markers
erythropoietin for infants with brain injuries due to oxygen deprivation at birth

Conditions: Asphyxia

Summary: erythropoietin (epo) is a hormone normally found in the body that may protect brain cells from damage due to lack of oxygen. this study will evaluate the safety of high-dose epo in infants who did not get enough oxygen during birth.

damage to the central nervous system as a result of oxygen deprivation at birth is a major cause of life-long mental and developmental handicaps. when there is not enough oxygen in the blood (hypoxemia) the brain is deprived of oxygen. some brain cells respond by producing epo. epo then binds to oxygen-deprived brain cells. this binding triggers chemical reactions within the brain cell that prevent cell death. epo also reduces inflammation around the brain cells and acts as an antioxidant. in animal studies, recombinant epo (repo) administration, even up to six hours after oxygen deprivation, reduced subsequent brain injury by 50% to 70%. epo has been used by neonatologists to stimulate erythropoiesis (red blood cell production) and reduce the incidence of blood transfusions. doses of repo required for protection of brain cells are considerably higher than those traditionally used by neonatologists. this study will evaluate the pharmacokinetics, biologic effect, and safety of high dose epo in neonates with brain injury due to hypoxemia. within six hours of birth, each eligible infant will receive one dose of repo intravenously. any infants who require a lumbar puncture during the first week of life will have levels of natural epo and repo in their spinal fluid measured. blood tests will be used to measure the antioxidant effect of epo and the impact on red blood cell production. neurodevelopmental outcome will be measured at 6 and 12 months of age.

Eligibility criteria:
inclusion criteria * infant 6 hours of age or less * apgar scores less than or equal to 3 at 1 and 5 minutes * weight greater than 2500 grams (5.5 lbs) * central venous line in place exclusion criteria * infants are ineligible if they do not meet the inclusion criteria above

Keywords: neurodevelopmental outcomes
serplulimab combined with chemotherapy in patients with resectable non-small-cell lung cancer

Conditions: NSCLC; Neoadjuvant Therapy

Summary: china with high incidence of non-small cell lung cancer. in the past few decades, surgery, radiotherapy, chemotherapy and other treatments were continuously improved, however, the mortality of lung cancer patients was not significantly decreased. for patients with locally advanced lung cancer, direct surgery is not effective. it is difficult to achieve radical resection by surgery merely, and even if many patients receive surgery, they may eventually have tumor recurrence and poor survival rate. therefore, it is necessary to explore effective perioperative neoadjuvant treatment to reduce the risk of postoperative recurrence and improve the postoperative survival rate of patients. according to the reports, pd-1/ pd-l1 immunocheckpoint inhibitor may become a new method for the treatment of lung cancer. preliminary clinical results showed that immunotherapy combined with chemoradiotherapy provided a synergies antitumor effect. multiple clinical results showed that serplulimab provided higher overall response rate for advanced lung cancer. however, in patients with locally advanced lung cancer, the efficacy of serplulimab combined with chemotherapy for sequential radical surgery is still unclear. the purpose of this study is to observe and evaluate the efficacy and safety of serplulimab combined with chemotherapy in the neoadjuvant therapy of resectable non-small cell lung cancer.


Eligibility criteria:
inclusion criteria: 1. signed informed consent; 2. patients age 18 to 75 years old 3. primary resectable, histologically confirmed non small cell lung cancer; 4. non small cell lung cancer the clinical stage was iia-iiib (no n3 patient) (according to ajcc tnm stage, 8th edition). 5. ecog ps 0-1. 6. the diseases could be resectable assessed by thoracic oncologist exclusion criteria: 1. with significant cardiovascular disease; 2. current treatment with anti-viral therapy or hbv; 3. female patients who are pregnant or lactating; 4. history of malignancy within 5 years prior to screening; 5. active or history of autoimmune disease or immune deficiency; 6. signs of distant metastases.

Keywords: serplulimab non small cell lung cancer neoadjuvant therapy
chronic pain after thoracotomy, an incidence study

Conditions: Thoracotomy; Chronic Pain

Summary: this is an investigation on the frequency of chronic pain after thoracotomy for lung cancer. factors relating to the development of chronic pain are investigated. questionnaire survey.


Eligibility criteria:
inclusion criteria: * able to understand and give consent * can read * residing in denmark exclusion criteria: * unable to understand the written information in danish * abuse (medicine, drugs, alcohol) * severe psychiatric illness * conflicting neurological disease

Keywords: thoracotomy chronic pain
niños sanos, familia sana - a multi-intervention program to prevent childhood obesity in mexican-heritage children in rural california

Conditions: Obesity

Summary: obesity and overweight are health problems resulting from the interaction of predisposing genes with environmental, economic and social stimuli, in conjunction with excess caloric intake throughout growth from childhood to adulthood. evidence suggests that a major barrier in controlling overweight/obesity is the complex interrelation of these factors, making single-approach interventions less likely to succeed than integrated, multi-faceted approaches. the proposed project aims to deliver a multi-faceted behavioral intervention developed over the past 18 months by a university-community /school-based collaborative. this project aims to provide new knowledge about the effectiveness of interventions designed specifically to achieve successful weight management among mexican-origin children ages 3-8, and identify associated mediating factors. deliverables will include community-based, collaborative and sustainable tools to support weight-management goals in this demographic. uc davis and uc cooperative extension (ucce) faculty form the investigator team, collaborating on key decision points with the project community in california's central valley. the investigators hypothesize that the identified mediating factors will increase fruit and vegetable consumption. the investigators also hypothesize an increase in the intensity and frequency of physical activity among children in the intervention group.


Eligibility criteria:
inclusion criteria: * family with child between ages 3-8 years exclusion criteria: * none

Keywords: child obesity mexican-american nutrition education intervention
long term efficacy and safety of tms targeting cerebellum to treat dre

Conditions: Drug-resistant Epilepsy; Transcranial Magnetic Stimulation

Summary: this study aims to observe the long term efficacy and safety of cerebellar continuous θ burst stimulation (ctbs) for drug-resistant epilepsy during enhanced and maintenance phase，in order to provide a new treatment for long-term control of drug-resistant epilepsy and improve the quality of life of those patients. a total of 100 patients with dre will undergo ctbs treatment by precise navigation to bilateral cerebellar dentate nuclei. the frequency and clinical feature of seizures, scalp eeg，clinical score, moca，mmse，and qolie-31 were ssessed at baseline, after 2 weeks of enhanced phase，8 weeks of consolidate phase, and 8 weeks of maintenance phase.


Eligibility criteria:
inclusion criteria: 1. age 18-65 years old， 2. participants who are diagnosed as drug- resistant epilepsy, 3. participants who has a history of dre ≥2 years before enrollment， 4. participants who has a seizure frequency of ≥2 seizures every month within 3 months before enrollment, 5. participants and their families are aware of this study and sign informed consent. exclusion criteria: 1. participants who are in status epilepticus, 2. participants who are complicated with serious infection, cerebrovascular disease, malignant tumor and other nervous system diseases, with serious dysfunction of heart, liver, kidney and other organs, and with psychiatric disorders, 3. participants plan invasive therapy, such as operation, 4. participants who are in pregnancy or lactating, 5. patients cannot tolerate repeated transcranial magnetic stimulation, or have contraindications of repeated transcranial magnetic stimulation.
midazolam used alone or sequential use of midazolam and propofol/dexmedetomidine in mechanically ventilated patients

Conditions: Mechanical Ventilation; Complication; Delirium

Summary: the purpose of this study was to evaluate effects, safety and cost of midazolam used alone or sequential use of midazolam and propofol/dexmedetomidine for long-term sedation in critically ill, mechanically ventilated patients.

it is well known that sedation is frequently required as a component of compassionate care in critically ill patients. until now, there is no ideal sedation drug and every sedation drug has its advantage and disadvantage for long-term sedation in critically ill, mechanically ventilated patients. the sequential use of midazolam and propofol for long-term sedation was associated with a faster recovery, earlier extubation, shorter mechanical ventilation time and less cost of total icu treatment compared with midazolam alone, the protocol was associated with less cost of pharmaceutical sedation compared with propofol alone. but, propofol and midazolam may cause respiratory depression and delirium. both drugs should be stopped after the patient passed the screen of weaning from mechanical ventilation, then it would induce the stress response and agitation, it would cause prolonged sedation and delay extubation. dexmedetomidine is a centrally acting a2-receptor agonist, has less effect on arousability and respiratory depression. the purpose of this study was to evaluate effects, safety and cost of midazolam used alone or sequential use of midazolam and propofol/dexmedetomidine for long-term sedation in critically ill, mechanically ventilated patients.

Eligibility criteria:
inclusion criteria: 1. intubated patients; 2. age≥18 years old; 3. anticipated ventilation and sedation duration of at least 72 hours. exclusion criteria: 1. allergy to the study drug; 2. suspected pregnancy; 3. gross obesity; 4. extremely unstable of circulatory system, such as systolic blood pressure less than 90 mm hg despite plasma volume expansion and continuous infusions of vasopressors before the start of study drug infusion; 5. uncontrolled abnormal hypertension, such as systolic blood pressure more than 180 mmhg or diastolic more than105 mmhg; 6. heart rate less than 50 bpm; 7. second or third degree heart block; 8. moribund state; 9. history of alcoholism or intake of anti-anxiety drugs or hypnotics; 10. chronic renal failure; 11. coma by cranial trauma or neurosurgery or unknown etiology or epileptic state; 12. history of neuromuscular disease; 13. unwillingness to provide informed consent by patients or their authorized surrogates following icu admission.

Keywords: sedation midazolam propofol dexmedetomidine
puberty, sex hormones and pain sensitivity in adolescents with migraine

Conditions: Migraine

Summary: the purpose of this research study is to investigate the relationships between sex hormone levels and experimental pain sensitivity and migraine severity will be examined.

this study will investigate how puberty and variability in sex hormone levels impact pain sensitivity and migraine symptoms. hypothesis 1- a significant reduction in pain sensitivity from early to late pubertal status will be found only for adolescents without but not with migraine during pubertal maturation. hypothesis 2- experimental pain sensitivity will be negatively correlated with testosterone levels in adolescents in both groups (with and without migraine). exploratory hypothesis 1- in adolescents with migraine, higher migraine severity (headache frequency and migraine disability) will be associated with lower testosterone levels. exploratory hypothesis 2- adolescents with migraine will have lower testosterone levels than those without.

Eligibility criteria:
inclusion criteria 1. age between 11-15 2. males and females 3. english speakers 4. migraine group: diagnosed with migraine 5. control group: healthy, with no first degree relative with migraine exclusion criteria: 1. pregnancy or breastfeeding, 2. chronic pain (except for migraine for the migraine group), neurological or psychiatric syndromes or syndromes associated with pubertal maturation 3. use of medications that impact sex hormone levels (i.e., contraceptive pills)

Keywords: pain puberty sex hormones
age-related clonal haematopoiesis in an hiv evaluation cohort (archive)

Conditions: HIV Infections; Aging

Summary: the archive study is an observational longitudinal cohort study of people with and without hiv who are over the age of 55. the duration of the study is planned for 10 years, with study visits every 1-2 years. the objectives of the study are to evaluate genomic and other factors associated with aging, stratified by hiv status.


Eligibility criteria:
inclusion criteria: * men and women aged \>55 * for participants without hiv: an hiv negative test within 12 months prior to enrolment. if no hiv-negative test result is available within 12 months prior to enrolment, then participants will be tested for hiv as part of standard of care, if indicated by the guidelines for hiv testing published by the australasian society for hiv, viral hepatitis and sexual health medicine14. this study will not conduct hiv testing; therefore, any participants without hiv being considered for participation in the study will need to have had a standard of care hiv negative test within the past 12 months. some subjects at on-going risk for hiv are recommended to have periodic hiv testing and may be due for such testing as part of standard of care, at the time of enrolment into the study. * willing and able to provide written informed consent and willingness to participate in and comply with a longitudinal cohort study including 1) consent to providing blood samples for full blood count, inflammatory marker testing and genomics analysis 2) consent to linking their data to national and state-wide data registries (including consent to providing personally identifying information); and 3) consent to participate in future follow-up studies exclusion criteria: - unwilling or unable to provide consent to participate
ultra-congruent(uc) versus posterior-stabilized(ps) insert in bilateral total knee arthroplasty

Conditions: Osteoarthritis, Ultra-Congruent(UC) Insert

Summary: numerous studies have echoed the superior clinical outcomes of posterior-stabilized (ps) total knee arthroplasty compared to posterior cruciate-retaining (cr) total knee arthroplasty. the post-cam mechanism of posterior-stabilized (ps) total knee arthroplasty has been postulated to provide reproducible femoral rollback and increased flexion. however, posterior-stabilized (ps) total knee arthroplasty systems are purportedly limited due to several post-cam related problems, including post-cam dislocation, wear and breakage of post, and patellar clunk syndrome. moreover, the post-cam mechanism requires additional bone resection and poses a risk for intercondylar fracture of the distal femur during box preparation. to overcome these issues, a fixed-bearing highly conforming ultra-congruent (uc) total knee arthroplasty was introduced. this study aims to compare the clinical results of ultra-congruent(uc) and posterior-stabilized(ps) insert in bilateral total knee arthroplasty.

the objective of this work was to compare pain, stiffness, function and accuracy between groups at minimum 2 year postoperatively. the investigators hypothesized that the ultra-congruent(uc) insert would provide similar functional outcomes without increasing the incidence of adverse events. the study design is a double-blind randomized controlled trial. fifty patients planed to undergo simultaneously bilateral total knee arthroplasty are randomised to be used ultra-congruent(uc) insert on one leg and posterior-stabilized(ps) insert on the other. the clinical outcome is comparative preoperative, postoperative 6weeks, 3months, 6months and 1years. and clinical score consists of range of motion (rom), womac (western ontario and mcmaster university arthritis index ) pain scale, knee society score, anterior and posterior stress view on x-ray.

Eligibility criteria:
inclusion criteria: * over 19 year old * patients for total knee arthroplasty of both knee * having medicare insurance exclusion criteria: * rheumatoid arthritis * other inflammatory arthritis * neuropsychiatric patients * hepatic insufficiency * renal insufficiency * over 40 of body mass index * chronic opioid use (taking opioids for longer than 3 months)
is internet-based self-help effective for the treatment of insomnia disorder?

Conditions: Insomnia Disorder

Summary: the swiss company mementor has recently developed an interactive self-help intervention for the treatment of insomnia entitled mementor somnium. this programme is based on the guidelines for cognitive-behavioural therapy. mementor somnium consists of 6 online sessions. an animated personal sleep coach provides relevant audio-information and asks questions to which the patient is invited to respond. the components of the programme flexibly adapt to the patient's responses. aside from psycho-education, exercises and an instruction for sleep restriction, mementor somnium includes a cognitive restructuring intervention in terms of a socratic dialogue. this socratic dialogue, implemented by the animated sleep coach, is based on a complex algorithm in the shape of an decision tree. university of zurich's department of psychology in switzerland will test the effectiveness of mementor somnium in a randomised controlled trial with three assessment times (pre, 6-weeks post and 3-months follow-up). patients suffering from insomnia will be allocated randomly to either the active intervention group or the waitlist control group. participants will have access to the programme mementor somnium for six weeks. primary outcome measure is the insomnia severity index, secondary outcome measures are beck depressions-inventory revised (bdi-ii), brief symptom inventory 18, and the sf-12 health survey. additionally, sleep diary data will be collected.


Eligibility criteria:
inclusion criteria: * insomnia disorder (dsm-5) * german language comprehension * internet-access exclusion criteria: * other sleep disorder * suicidality * current psychotherapy * drug abuse or recent change in medication